Piperacillin pharmacokinetics in patients with chronic renal failure

Piperacillin sodium is currently and ivestigational drug undergoing Phas III clinical trials. The drug is a penicillin derivative. Piperacillin has been shown to be effective in the treatment of serious infections. In vitro and in vivo studies demonstrate that Piperacillin has a broad spectrum of activity. It is effective against most gram-positive and gram-negative organisms including anaerobes. Its gram-negative spectrum includes Escherichia coli, Enerobactere cloacae, Proteus mirabilis (indole-negative Proteus), Proteus vulgaris (indole-positive Proteus), Serratia marcescens and Klebsiella pneumoniae. It is four to eight-fold more active than carbenicillin in inhibiting Pseudomonas aeruginosa and folds-fold more active against Bacteriodes fragilis. The pharmacokinetics of Piperacillin have been studied in patients with normal renal function and dosage recommendations are fairly well established for this group of patients. Very little work has been done on the pharmacokinetics of this drug in patients with end-stage renal failure. Due to the increased risk of infection in this population, Piperacillin may be an important drug in the treatment of infections in this group.